Health & Wellness Advisor II LMSW (HIV Care)
Company: MetroPlus Health Plan
Location: New York
Posted on: April 24, 2024
Job Description:
Health & Wellness Advisor II LMSW (HIV Care)
Job Ref: 88967
Category: Utilization Review and Case Management
Department: PARTNERSHIP IN CARE
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Full-Time
Salary Range: $83,000.00 - $83,000.00
Empower. Unite. Care.MetroPlusHealth is committed to empowering New
Yorkers by uniting communities through care. We believe that Health
care is a right, not a privilege. If you have compassion and a
collaborative spirit, work with us. You can come to work being
proud of what you do every day.About NYC Health +
HospitalsMetroPlusHealth provides the highest quality healthcare
services to residents of Bronx, Brooklyn, Manhattan, Queens and
Staten Island through a comprehensive list of products, including,
but not limited to, New York State Medicaid Managed Care, Medicare,
Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold,
Essential Plan, etc. As a wholly-owned subsidiary of NYC Health +
Hospitals, the largest public health system in the United States,
MetroPlusHealth'snetwork includes over 27,000 primary care
providers, specialists and participating clinics. For more than 30
years, MetroPlusHealth has been committed to building strong
relationships with its members and providers to enable New Yorkers
to live their healthiest life.Position OverviewUnder the direction
of the Director of Care Management (PIC), the Health & Wellness
Advisor Level 2 (SW) ensures the promotion of health and wellness
of HIV-positive, homeless, and transgender members through the
development and oversight of an evidence-informed, individualized
Plan of Care that addresses their complex medical, behavioral
health and social service needs. This position may be deployed,
based on business needs, to health care facilities throughout New
York City to provide case management services.Job Description
Provides telephonic and/or
face-to-face care management services to members at designated HIV
primary care facilities, including care coordination, transition of
care, out-patient follow-up, and ancillary service review to ensure
optimal health outcomes.Develops and implements an individualized
member Plan of Care utilizing various resources, including, but not
limited to member, family care giver, primary care provider, and
facility-based or community-based care manager, focused on health
coaching and care coordination activities, aligned with member
needs and preferences in reaching their health goals.Promotes
access to and oversees the coordination and delivery of
comprehensive, quality healthcare services for HIV-positive,
transgender, and homeless members.Provides health education and
coaching on HIV disease, HIV primary and secondary risk reduction,
and other chronic co-morbid illness, including, but not limited to
hepatitis C, diabetes and hypertension as indicated by the Plan of
Care.Communicates with the member's primary care provider,
community case manager and all other applicable providers, vendors,
or agencies to facilitate the health and wellness of the member in
a coordinated and comprehensive manner.Identifies service
utilization trends and potential member needs through review of
encounter data, pharmacy/prescription data, completed member health
assessment tools.Ensures that goals, interventions, and care
coordination activities for each member are documented in the
electronic health record in compliance with professional standards
and regulatory guidelines.Mentors and supports the work of HIV
Services Health & Wellness Advisors (Level 1) on their assigned
team and other teams when requested and participates in the
competency development of HIV Services Health & Wellness Advisors
(Level 1).Attends and prepares for periodic departmental case
conferences as assigned. Reviews, identifies, and assesses the
member Plan of Care and recommends changes to promote the health
and wellness of the member.Assists other MetroPlusHealth
departments with resolution of member concerns related to
retention, utilization management, quality management, customer
service, and provider relations.Attends approved in-service and
external education and training as per department
directives.Performs, as assigned, other special projects and
activities, including, but not limited to, audit review and
preparation, quality improvement, community health education,
facility/provider relations and health plan promotion.Ensures that
coordination of care activities for assigned caseload is compliant
with Federal, State, and City regulations, and is consistent with
the Mission, Vision and Values of the organization.Minimum
Qualifications
Master's degree from an accredited
college or university in Social Work is required.A minimum of two
years of clinical experience in HIV care or support systems that
includes experience in care coordination, health education and case
management.Experience in managed care is preferred.Bilingual
(English/Spanish) is preferred. Fluency in other languages is
welcome.New York State license as an LCSW or LMSWProfessional
Competencies
Integrity and TrustCustomer
FocusFunctional/Technical SkillsExcellent interpersonal,
organizational communication and analytical skillsComputer literacy
with proficiency with Microsoft Office products is
required#LI-Hybrid
Keywords: MetroPlus Health Plan, New York , Health & Wellness Advisor II LMSW (HIV Care), Healthcare , New York, New York
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